【作者】 屈大望； 于振涛； 金庆文； 刘向明； 张帆；

【Author】 QU Da-Wang Zuang Fan Liu Xiang-Ming Department of Esophageal Tumor, Tianjin Medical University Cancer Hospital, Tianjin 300060, P.R.China

【机构】 天津医科大学附属肿瘤医院食管肿瘤科；

【摘要】 目的:探讨75岁以上高龄食管中下段癌及贲门癌患者外科治疗的最佳手术方式。方法:2003年4月～2006年 3月采用左上腹旁正中联合胸小切口治疗75岁以上高龄食管中下段癌及贲门癌11例(最大年龄92岁)。手术首先仰卧位, 腹部垫高,取上腹部左侧剑突与肋弓交点水平经旁正中切口进入腹腔,解剖游离大小网膜,清除区域淋巴结。扩张膈食管裂孔,充分游离食管下段上至胸内最高处,关闭腹腔。第二步翻身左(或右)侧卧位,经胸第6肋床或肋间水平后外侧小切口进胸,以最短时间在胸部游离食管清除区域淋巴结,由胸食管裂孔处上提腹部游离好的胃组织,切除肿瘤,行食管-- 胃吻合术。结果:本组11例患者手术顺利,术后ICU监护, 10例无手术相关并发症,术后2周出院。1例术后并发健侧肺部感染、胸腔积液,经治疗一月后出院。结论:此手术方法, 开胸时间短,对心肺功能影响小,是减少胸部消化道肿瘤外科切除后并发症,特别是心肺并发症,降低术后死亡率的一种值得选择的手术方式,尤其对于75岁以上高龄老年食管中下段癌及贲门癌患者的外科临床应用有一定的推广价值。更多还原

【Abstract】 Objective: To evaluate the optimal operative method for senile patients of middle-lower esophageal and cardiac cancer. Methods: from April 2003 to March 2006,11 esophageal and cardiac cancer patients over 75 years old (the oldest one was 92) were operated using upper-left Paramedian abdominal and small-scaled thoracic approaches. Results: 11 patients were operated successfully, all of them were radically cured, none has any surgical complications, and the surgery-related mortality was 0. Conclusion: This method shortened the time of thoracotomy, decreased the operative interference to heart and lung functions, avoided postoperative complications, especially cardiopulmonary complications. This method is safe and effective for senile patients with middle-lower esophageal or cardiac cancer.更多还原